12 steps to the West

W hen Emerson Charlie checked himself into Friendship House on June 1, 2010, he was nursing a bad hangover and a worse attitude.

He scowled around the room, "wondering who would be the first person to fight me." But he only encountered welcoming smiles.

It was outing day, and the detoxing Native American alcoholics at the residential treatment center in San Francisco were bound for the popular tourist destination Pier 39.

Charlie's aching head pounded even more at the thought of spending the day in the sunlight.

"Can't I just stay here?" he whined.

"No," came the counselor's reply. "Around here, we do things as a group."

It's that group approach, even more than the talking circles and sweat lodges, that set Friendship House apart, said Gordon Nez, the program's Fort Defiance-based case manager for Navajo clients.

"I hate to say it, but a lot of the treatment options available on reservations are based on a traditional BIA model where you're basically a number," Nez said. "When you think about Natives, our ceremonies, every important milestone in our lives, we do it surrounded by family and community. You can't just process us through one at a time."

Unfortunately, a lot of alcoholics either have dysfunctional families or have long since alienated every relative who ever tried to help them.

So at Friendship House, "they get what amounts to a functional, sober family in a community environment," Nez explained.

It worked for Charlie, who just celebrated his 20th month of sobriety. He's still living in the Bay Area, working as a maintenance man and going to school to become a drug and alcohol counselor.

It's hard to get by in the city on a maintenance worker's salary, and he sometimes misses his "good government job" as a lab technician in Gallup before he started drinking and wound up on the streets.

"But I'm happy," he said. "I'm really happy, for the first time in a long, long time."

When he craves a drink, "I just think back to my old life on the streets," he said. "I don't want that life ever again."

Charlie is one of more than 250 Diné who have passed through the Friendship House Association of American Indians Inc. of San Francisco in the past four years, since the program (whose executive director, Orlando Nakai, is Diné) partnered with the Navajo Nation's Division of Health to provide culturally specific addiction treatment to Navajos.

Diné alcoholics and drug addicts who want to enter the program (or are court-ordered to, or referred by Behavioral Health) meet with Nez, who helps them with the paperwork and sees if they qualify for state funding under Arizona's Health Care Cost Containment System.

If so, they're put on the next bus to San Francisco, where they find a program that, two states away, is surprisingly familiar.

That's because it's run by Navajos. In addition to Nakai, Chief Executive Officer Helen Devore Waukazoo is also Diné.

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"As a Navajo woman and co-founder of Friendship House, this work is particularly important to me," Waukazoo stated in a press release. "The high rate of domestic violence, family conflict, substance abuse and other conditions experienced by our people is very unsettling to me, and this is what further motivates me in this work each day."

In addition to trained addiction counselors, they'll encounter traditional practitioner Steven A. Darden (Diné/bilagáana), who visits the program periodically from his home in Flagstaff to pray with the clients and provide traditional counseling.

"A lot of our clients say that, in addition to helping them get sober, we helped reconnect them with their cultural roots," Nakai said.

Added Nez, "It's a holistic approach that tends to their spiritual needs as well as the mental and physical."

With up to three 90-day rotations, it's also a much longer stay than most residential treatment facilities provide.

"All the studies show that the longer you can keep people, the better chance they have of staying sober," Nez said. "And yet, we keep trying to cut corners with outpatient programs. Outpatient programs work for a client who's typically employed, engaged with his family, and has a home and transportation."

This does not describe the majority of serious Navajo alcoholics, Nez said.

"How are they supposed to get to their appointments if they don't have a home, if they don't have family support, if they don't have transportation?" he said.

"You could say, 'They seem to be able to hitchhike into Gallup for a drink,' and that's true," he added. "Give an alcoholic the choice of a counseling session or a drink, he's going to choose the drink. That's why he needs the counseling."

The one drawback to Friendship House is that it's not cheap. So far ACCCS has continued to pay for participation for low-income Navajos living in Arizona, but with the state dealing with a deficit, Nakai and Waukazoo live in fear of the budget axe.

Nez thinks that when it comes to addiction treatment, taxpayers need to take a long view.

"Compare the cost of a person sobering up to the cost of a person spending their life as a drunk, and the cost becomes irrelevant," he said.

"I was really lost," Davis said. "As long as I was on the reservation, I kept ending up in Farmington on the streets. I really needed to get away. My sister suggested Friendship House and bought me a bus ticket."

Davis is coming up on two years of sobriety. He's living in Oakland, working and studying to be an X-ray technician so he can come back to the rez, work in an IHS facility and help his aging mother on her ranch in Lukachukai.

He's been away from the Navajo Nation a while now, but when he talks about Friendship House, he lapses into Diné bizaad.